Study On The Clinical Value Of FeNo Detection In Bronchial Asthma With Different Inflammatoyr Phenotypes

Objective: To clarify the value of exhaled nitric oxide?abbreviated FeNO?in the diagnosis and therapeutic evaluation of bronchial asthma with different inflammatory phenotypes,and to determine whether FeNO has a correlation with lung function indicators in bronchial asthma with different inflammatory phenotypes.To provide guidance in diagnosis and treatment and efficacy evaluation for this heterogeneous diseases.Methods: 110 cases were included in the study,of which 90 cases were in the experimental group?asthma group?and 20 cases were in the healthy control group.Before treatment,the experimental group was divided into four inflammatory phenotypes based on the cellular components in the blood routine.Among them,34 were in the eosinophilic asthma group?EA group?,16 in the neutrophil asthma group?NA group?,13 in the mixed granulocyte asthma group?MA group?,and the oligocellular asthma group?PA group?were 27 cases.Before treatment,patients in the experimental group were tested for FeNO,lung function tests,and asthma control scores?ACT?were filled out.For healthy control groups,FeNO was measured.ROC curves were used to determine the significance of FeNO in diagnosing different phenotypes of bronchial asthma.Appropriate treatment,review of FeNO and pulmonary function and fill in the asthma control score?ACT?after one week and one month of treatment,use Pearson correlation analysis to analyze the correlation between FeNO and lung function and ACT,to evaluate the value of FeNO in the efficacy evaluation of bronchial asthma with different inflammatory phenotypes,and to evaluate the correlation between FeNO and pulmonary function indexes in the efficacy evaluation of bronchial asthma with different inflammatory phenotypes.Results: 1.The FeNO values of the four groups of asthma patients were different.The FeNO value of eosinophilic asthma is?92.47±43.16?bbp,and the FeNO value of mixed granulocytic asthma is?82.77±32.53?bbp.Compared with normal people?24.6±10.36?bbp,the difference was statistically significant?P<0.05?.The neutrophil asthmaFeNO value is?36±14.48?bbp,and the paucigranulocytic asthma FeNO value is?32.04±13.61?bbp.Compared with normal people?24.6±10.36?bbp,the difference was not statistically significant?P>0.05?.There were statistically significant differences in eosinophilic asthma,mixed granulocyte asthma,neutrophil asthma,and oligocellular asthma?P<0.05?.2.The FeNO value is helpful for the diagnosis of eosinophilic asthma.The optimal threshold is 36 bbp,the specificity is 75%,the sensitivity is 82.4%,the area under the ROC curve is 0.854,and the 95%confidence interval?0.755-0.954?.The specificity of leave a cross-validation is 75%,and the sensitivity is 82.4%.FeNO is helpful for the diagnosis of mixed granulocytic asthma.The optimal threshold is 44 bbp,the specificity is 75%,the sensitivity is 84.6%,the area under the ROC curve is 0.862,and the 95% confidence interval?0.736-0.987?.The specificity of leave a cross-validation is 75%,and the sensitivity is84.6%.FeNO has little value in the diagnosis of neutrophil asthma and oligocellular asthma.3.In eosinophilic asthma,there is a negative correlation between FeNO and FEV1% after treatment,of which one week after treatment?r₁=-0.521,P = 0.002?and one month after treatment?r₂ =-0.468,P =0.005?,and there is a negative correlation with ACT,in which after one week of treatment?r₁ =-0.554,P = 0.001?,after one month of treatment?r₂ =-0.431,P = 0.011?.It has been shown that FeNO can help evaluate the efficacy of eosinophilic asthma.There is no correlation between FeNO and pulmonary function and ACT in mixed granulocytic asthma,neutrophil asthma and oligocellular asthma,suggesting that FeNO cannot be used to evaluate the efficacy of these three types of asthma.Conclusion: 1.The determination of FeNO is helpful for the diagnosis of eosinophilic asthma and mixed granulocyte asthma,but it has no value of diagnostic in neutrophil asthma and oligocellular asthma.2.FeNO in eosinophilic asthma can be rapidly reduced after anti-inflammatory treatment,and has a negative correlation with lung function indicators,which is helpful for the evaluation of asthma curative effect.There is no correlation with pulmonary function indicators in the efficacy evaluation of granulocytic asthma,neutrophil asthma,and oligocellular asthma,and it has no therapeutic effect evaluation value.